he increasing rates of fatty liver disease — an excess build-up of fat around the liver, which could eventually progress to inflammation and end-stage liver disease — is a global phenomenon, which has been in evidence in Kerala too in recent years.
At a time when deceased donor organ transplantation has caught on in the State in a major way, the rising prevalence of fatty liver disease could have a significant impact on the number of viable donor livers available for transplant, surgeons fear.
A look at the figures showing the number of deceased organ donations reported with the Kerala Network for Organ Sharing, the nodal agency coordinating the State government’s ‘Mrithasanjeevani’ cadaver organ donation programme and the actual number of donor livers found viable for transplant, indicates that these fears are not misplaced. (See chart)
In a State where over 20 per cent of the adult population has diabetes and over 30 per cent has hypertension, it is not surprising that non-alcoholic fatty liver disease (NAFLD — linked to diabetes, high blood pressure, elevated lipid levels and abdominal obesity) is steadily on the rise. Fatty liver is a vulnerable liver for transplant as it can have functional issues in an organ recipient, especially if he has other health issues.
Liver with over 50 per cent fat deposition is totally unacceptable, while a liver with up to 30 per cent fat, though sub-optimal in quality, is accepted for transplant if the recipient is relatively healthy.
NAFLD is a reversible condition to a certain extent because controlling the diet, lifestyle modifications and reducing body weight can reduce the fat deposition in the liver too.
“Almost 90 per cent of the liver transplants currently happening in the country are live donations. This means that once the matching donor has been found, he/she could be put on medication and body weight reduction to reduce the fat on the liver significantly, making the organ viable for transplant,” says K.R. Vinayakumar, former Head of Gastroenterology, Thiruvananthapuram Medical College.
However, the organ transplantation scene in Kerala is currently poised for a paradigm shift from live to deceased donor organ donation and thus the viability of donor livers available for transplant becomes extremely important, Dr. Vinayakumar points out.
At present, Almost 90 per cent of the liver transplants in the country are live donations.
